小児心臓手術後におけるデクスメデトミジンと抑肝散併用療法の鎮静効果

抄録

Objectives: The study was conducted to compare the combined effect of dexmedetomidine (DEX) and oral or suppository Yokukansan (YKS) on sedation after cardiac surgery in pediatric patients. Methods: Eighteen postoperative patients were divided into three groups according to YKS combined with continued administration of DEX: non-YKS (NY) group, gastric tube (oral) YKS (GY) group, and intrarectal suppository YKS (RY) group. YKS was administered at a dose of 0.1 g/kg every four hours. The sedation level was evaluated using Richmond Agitation-Sedation Scale and Behavioural Observational Pain Scale, and ketamine was administered for patients with scores ≥2 in either scales. The total dose of ketamine administered per body weight was used to define the sedative effect. Results: The ketamine dose (median) was 1.5, 1.0, and 0 mg/kg/day in NY, GY, and RY groups, respectively. Compared with the NY group, the GY group used less ketamine but the difference was not significant (P=0.49) and the RY group used a significantly lower dose (P=0.03). Conclusions: The combination of DEX and suppository YKS was effective for sedation in children after cardiac surgery, while DEX combined with gastric tube (oral) YKS was not sufficient in efficacy.